by Cathy Payne, USA TODAY

by Cathy Payne, USA TODAY

People may be struggling with gas prices and health care costs, but cosmetic plastic surgery procedures rose 5% from 2011 to 2012, the American Society of Plastic Surgeons reports. Last year, 14.6 million procedures, including minimally invasive and surgical, were performed in the U.S., according to the organization's annual statistics.

"For the third consecutive year, the overall growth in cosmetic surgery continues to be driven by a significant rise in minimally invasive procedures, while surgical procedures remain relatively stable," ASPS President Gregory Evans said in a statement. Minimally invasive procedures include treatments such as Botox, chemical peels and laser hair removal.

Evans says the statistics may show that people are spending more on the minimally invasive procedures because they have less discretionary income to use for surgical procedures, such as liposuction. Cosmetic surgery is usually not covered by health insurance because it is elective.

He says the data also may show that people have taken better care of themselves so they turn to minimally invasive procedures before surgical ones.

Minimally invasive procedures, which surpassed 13 million last year, increased 6%. The top minimally invasive procedure was botulinum toxin type A, such as Botox and Dysport. The injection reduces wrinkles, such as frown lines.

Cosmetic surgical procedures, which almost reached 1.6 million last year, decreased 2%. Breast augmentation remains the top surgical procedure.

Andrew Da Lio, of Ronald Reagan UCLA Medical Center, says the higher number may reflect increased levels of obesity and more social acceptance of men having plastic surgery.

Reconstructive plastic surgery, which improves the appearance and function of abnormal structures like scars, was up 1%. Last year, 5.6 million procedures were performed. The top procedure was tumor removal. Many health insurance policies cover reconstructive surgery, but the levels vary.

Evans urges people to do their homework before getting plastic surgery to minimize any risks. He says people can find board-certified plastic surgeons through the website of the ASPS, which is based in Arlington Heights, Ill.

UCLA's Da Lio, a professor and chief of plastic and reconstructive surgery, says each procedure has its own risks. For example, he says breast augmentation carries the risk of a breast implant hardening or rupturing.

Da Lio says patients should think about the extent of the results and the quality of work they want. They also should decide how much money and time they are willing to spend.

He says the Internet opened access to information for those thinking about plastic surgery. "Patients are more informed," he adds. "Patients have to be informed. They have to know what they are getting into."